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Surgical Servicesdr zablotsky

Dr. Zablotsky’s practice provides a variety of surgical services. He prides himself on the fact that he is very conservative in his treatment recommendations and limits surgery to the areas where it is absolutely necessary. Periodontal procedures are available to regenerate the bone and gum tissue to their original function and cosmetic appearance.

Please use the drop down menu, above right, to choose a surgical service of interest.

Cosmetic Periodontal Surgery

These procedures are a predictable way to cover sensitive or exposed root surfaces and to prevent future gum recession. If you are unhappy with the appearance of short unsightly teeth this can be greatly improved by a combination of periodontal procedures by Dr. Zablotsky and cosmetic dentistry by your dentist.

Gum Grafting Procedures

(Subepithelial connective tissue grafts)

When the gums are thin and weak due to a lack of tough attached tissues, recession can occur. Many feel that when this occurs the area may be more susceptible to bacterial penetration and trauma. When gum recession is a problem gum reconstruction using grafting techniques is an option.

Risk Factors for the Progression of Recession when tissues are thin include:

Tooth brush abrasion

Biting overload. This can occur from grinding or clenching your teeth

Increased functional load, i.e. supporting teeth for bridges or partial dentures with thin tissues.

Planned orthodontic therapy

Sensitive exposed roots

Root exposure with high smile line (esthetic concerns)

Ill fitting restorations under the gumline or those which are too deep violating gum attachments ("biologic width"). View a restorative case study image.

When there is only minor recession, some healthy gingiva often remains and protects the tooth, so that no treatment other than modifying home care practices is necessary. However, when recession reaches the mucosa (loose, moveable tissue), the first line of defense against bacterial penetration is lost.

In addition, gum recession often results in root sensitivity to hot and cold foods as well as an "long in the tooth" appearance to the smile. Also, gum recession, when significant, can predispose the area to root decay and gouging as the root surface is softer than enamel.

A gingival graft is designed to solve these problems. A thin piece of tissue is taken from the roof of the mouth, or gently moved over from adjacent areas, to provide a stable band of attached tissue around the tooth. The gingival graft may be placed in such a way as to cover the exposed portion of the root.

The gingival graft procedure is highly predictable and results in a stable healthy band of attached tissue around the tooth. Dr. Zablotsky is one of the first periodontists in the Sacramento area to integrate a surgical microscope into his patients’ periodontal plastic surgical care.

On occasion, various forms of biological membranes can be used as a substitute for palatal donor tissue to accomplish the goal of root coverage and toughening the attached tissues.

Finally, previously restored root surfaces (either bonded or crowned surfaces) can oftentimes be grafted to eliminate the "long tooth" look and cover the exposed root surface.

before gum graftafter gum graft

View other graft and membrane case study images

Crown Lengthening

When decay occurs below the gumlike or if a tooth exhibits significant breakdown, it may be necessary to remove a small amount of bone and gum tissue. Your dentist may ask for this procedure before he or she makes a new crown for your tooth. This is crown lengthening to attain a healthy functional result.

reshaping the gum
Reshaping The Gum and Supporting Tissues:
This will allow your general dentist adequate room to place a quality final restoration.

final restoration
Final Restoration

Esthetic crown lengthening may be done to facilitate a crown or veneer. Oftentimes it is indicated when the patient has a "gummy smile" with short looking teeth or when the gumline is uneven. Oftentimes other disciplines (i.e. orthodontics and cosmetic dentistry) are utilized in addition to esthetic crown lengthening surgery to attain a more ideal result.

before esthetic crown lengtheningafter esthetic crown lengthening
Before and after orthodontics, esthetic crown lengthening and veneers.

View additional crown lengthening case study images

Osseous Surgery

Traditionally, gum disease is oftentimes treated by eliminating the gum pockets by trimming away the infected gum tissue and by gently re-contouring or reshaping the uneven bone tissue. Although this is still an effective way of treating gum disease, oftentimes new and more sophisticated procedures are also utilized routinely today.

Bone Grafting

Over a period of time, the jawbone associated with missing teeth atrophies or is reabsorbed. This often leaves a condition in which there is poor quality and quantity of bone suitable for placement of dental implants. In these situations, most patients are not candidates for placement of dental implants.

bone grafting

We now have the ability to grow bone where needed. This gives us the opportunity to place implants of proper length and width, and it also gives us a chance to more effectively restore esthetic appearance and functionality.

Ridge Augmentation

The effects of tooth loss on the remaining gum and bone form can be devastating. Studies show that significant loss of the height and width of the ridge occurs as early as 6-12 months after extraction and may continue for years. You may have seen people who have a loss of gum contour with spaces under and between bridge replacement teeth. Not only is this unaesthetic, but patients often complain about speech difficulties and problems with food impaction. Many times reconstruction of lost form and function can occur via bone or soft tissue augmentation grafting techniques to regenerate lost structure.

before ridge augmentationafter ridge augmentation

View all ridge augmentation case study images

Dr. Zablotsky is the first dental surgeon in the Sacramento area to utilize the patient’s own growth factors to enhance bone regeneration procedures. The procedure utilizes a small amount of the patient’s blood, which is then separated into its constituent parts. One fraction of the plasma (the fluid the circulating red blood cells are suspended in), the platelet rich component, has many growth factors which have been shown to be important in soft and hard tissue wound healing. The platelet rich plasma (PRP) is then mixed with bone grafting materials as a biological carrier and is also utilized as a soft tissue "glue".

Visit www.pacificautotransfusion.com for More information

Ridge Preservation

Careful management of extraction sockets after tooth extraction prevents disfiguring bone loss and leads to a better cosmetic outcome of tooth replacement. Whenever a tooth within the esthetic zone (within the gummy area in the viewable smile line) is to be extracted or in sites which may later receive dental implants it is advisable to consider socket/ridge preservation bone grafting. This will slow the process of gum and bone collapse. This atrophy occurs after the extraction of teeth and grafting allows for less shrinkage and a more esthetic tooth replacement (either implant crown or fixed bridge around the replacement teeth).

Guided Tissue Regeneration

This surgical procedure "regenerates" the previously lost gum and bone tissue. Most techniques utilize membranes, which are inserted over the bone defects. Some of these membranes are bio-absorbable and some require removal. Other regenerative procedures involve the use of bioactive gels.

guided tissue regenerationguided tissue regeneration

View all X-rays of tissue regeneration case study images

Distraction Osteogenesis

Many surgical procedures have been touted to produce significant increases in the height or width of the jawbone for preprosthetic surgery. Unfortunately, it has been historically very difficult and unpredictable to regenerate tissues in a vertical direction. Recently, surgical procedures have evolved to enable surgeons to more predictably address vertical deficiencies for either subsequent implant placement or ridge regeneration prior to conventional crown and bridge work. For more information on the history and technique for this modality link to distraction.net